ArticleEarly intervention in psychiatry2025
Identifying and managing treatment resistance early with the integration of a clozapine clinic within an early intervention for psychosis service.
Article in Early intervention in psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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Who cites it
5 citing papers in PubMed.
- Identifying Clinical Characteristics of Young People with Treatment-Resistant Schizophrenia Undergoing Community Initiation of Clozapine.Schizophrenia bulletin · 2026Article
- Adult psychiatrists' views on clozapine prescribing for schizophrenia in Germany-an online survey.Therapeutic advances in psychopharmacology · 2026Article
- A multidisciplinary approach to establishing clozapine in a patient with schizophrenia and comorbid ASD: a case report.BMC psychiatry · 2025Article
- Which Sociodemographic and Pathway to Care Factors Influence the Wait Time for Early Intervention for Psychosis? A Mental Health Electronic Health Records Analysis in South London.Early intervention in psychiatry · 2025Article
- Identifying and managing treatment resistance early with the integration of a clozapine clinic within an early intervention for psychosis service.Early intervention in psychiatry · 2025Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite being the most effective antipsychotic medication for treatment-resistant psychosis, clozapine is often under-utilized with long delays to initiation.
aimsThis study aimed to determine whether the integration of a clozapine clinic within an early intervention for psychosis service resulted in a change in the rate and time to initiation of clozapine, the number of trials of different antipsychotic medications prior to clozapine, community initiation and discontinuation rates.
methodsA clozapine clinic was established in the Early Psychosis Prevention and Intervention Centre in Melbourne. This was a pre- and post-evaluation study design. The 'clozapine clinic' cohort included those who commenced on clozapine from 01 January 2016 to 30 June 2018.
resultsPrior to the clozapine clinic, 24 young people commenced clozapine over the 30-month period compared to 36 in the clozapine clinic cohort (RR = 1.30, 95% CI: 0.75-2.28, p = .32). In the pre-clozapine clinic cohort, 4.6% of all those with a first episode of psychosis were commenced on clozapine compared to 6% in the clozapine clinic cohort. Prior to the clozapine clinic, the median time to the commencement of clozapine was 72 weeks (IQR: 38, 87), compared to 53.5 weeks (IQR: 38, 81.5) in the clozapine clinic (Z = -0.86, p = .393). The mean number of different antipsychotic medications prior to commencing clozapine remained stable at 3.2 (SD ± 1.1) in both cohorts (t = -0.20, p = .841). There was a lower rate of discontinuation in the clozapine clinic (43.5% vs. 14.7%, HR = 0.30, 95% CI: 0.09-0.98, p = .046).
conclusionsWhile this study was underpowered and there are limitations to the naturalistic study design, the findings lend support to the integration of a clozapine clinic within early intervention for psychosis services.
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